If you have an older friend or relative who has been diagnosed with Alzheimer’s disease, you know how devastating that diagnosis can be. Probably most people are unaware, however, that up to 30% of people diagnosed with Alzheimer’s are misdiagnosed, and that about 20% of all cases of dementia are actually treatable.
The August 27 edition of the Wall Street Journal (USA), contained an extensive article “Detective Work: The False Alzheimer’s Diagnosis”. it is worthwhile that we also discuss this problem here, especially to alert people that some cases of dementia can be treated, even cured.
In research supported by the National Institute of Aging (USA) and published in the April issue of the Journal of Neuropathology and Experimental Neurology, doctors studied autopsy data from about 1000 people diagnosed with Alzheimer’s disease. They found that up to 30% had other causes for their dementia, and not Alzheimer’s disease.
It is understandable that doctors might over-diagnose Alzheimer’s, as the only sure way to make the diagnosis is by autopsy (not so good for living, breathing people!). Sometimes the cause of dementia is not known for sure, and patients are diagnosed with “Alzheimer’s”, which indeed does account for 60 to 80 percent of dementia cases.
In fact though, some of these individuals have another cause of dementia such “vascular dementia” (a series of silent “mini-strokes”), or “mild cognitive impairment” (milder than Alzheimer’s), Parkinson’s disease, or a brain infection such as Creutzfeldt-Jakob disease, among others. Like Alzheimer’s, these forms of dementia do not have a cure, but the critical issue is to recognize when a patient really has a treatable cause for dementia, and not Alzheimer’s as was suspected.
Here are some of the major treatable, possibly curable causes of dementia:
1. Some prescription medication can mimic dementia, especially when an elderly person is on multiple medications, often received from several different doctors, none of who might be aware of all the medications the patient is taking.
There are over 100 different drugs that have side-effects that can mimic Alzheimer’s, and here are some of the types: antihistamines, sleeping pills, pain pills, anti-anxiety or anti-psychotic drugs, certain older anti-depressants, acid-reflux drugs, cholesterol-lowering drugs, incontinence drugs, anti-reflux drugs, blood pressure medication, tranquilizers, heart drugs, stomach medication, and drugs for Parkinson’s disease;
2. Severe depression;
3. Toxic reaction to alcohol or illicit drug use;
4. “Normal pressure hydrocephalus” which is a build-up of fluid within the brain, and when the fluid is removed, the person can return to normal;
5. Hormonal imbalances or nutritional deficiencies such as vitamin B12 and folic acid;
6. Severe systemic kidney, liver, lung disease, or brain tumors.
The bottom line is: if someone is diagnosed with Alzheimer’s disease, it is important for family members or other care-givers to be aware of these other potential causes of dementia, and make sure the doctor(s) do a complete exam and testing such as a brain scan, blood tests, possibly a spinal tap, and sometimes even more sophisticated types of brain scans. Always a careful look at the patient’s medication list is necessary.
Of course you don’t want to assume that a loved-one’s dementia might be due to, for example, a medication and stop that medication without consulting the doctors. A good idea is to have a complete evaluation by a neurologist, but everyone, doctors and family, be alert for other potential diagnoses.
Should you wish to find a neurologist or other specialist in Brazil, see our main website: www.procuramed.com
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